Depression casts a dark cloud over a person's whole existence each day.  A man cannot overcome it by showing more backbone.  A woman cannot simply shake off the blues.

How to Recognize Clinical Depression

Depression is different from the "blues."  By using the following list of symptoms a person can recognize whether he or she is suffering from a clinical depression:

• Depressed mood
• Decreased interest or pleasure in usual activities
• Significant change in appetite or weight
• Sleep disturbances
• Restlessness or sluggishness
• Fatigue or loss of energy
• Unexplained aches or pains
• Poor concentration or indecision
• Feelings of worthlessness, inappropriate guilt
• Thoughts of death or suicide

A diagnosis of major depression is likely in the following instances:

• An individual shows either of the first two symptoms and four of the remaining seven
• Those symptoms continue for two weeks or more
• The person's functioning is impaired

The diagnosis of major depression can be made only after a complete mental health examination has been done.  In some cases a physical exam may also be necessary.

Treatment

Psychotherapy can help depressed individuals recognize the issues that have contributed to the onset of their depression.  One type of treatment is Cognitive-behavioral Psychotherapy.  It has  been shown to work effectively with most depressed individuals.  This approach to treatment helps to relieve the symptoms of depression and assists individuals to develop new ways of thinking and acting that serve them better.

Understanding what one is thinking and feeling can help a depressed person cope more effectively.  Talking with a therapist can minimize isolation, restore a sense of hope, and assist in taking positive steps toward more satisfying functioning.

In most instances psychotherapy is combined with medication (prescribed by a physician) for the best results.

Depression and Older Adults

About 8% to 20% of older adults who live out in the community suffer depressive symptoms.  The number increases to 37% among those who live in institutional settings.  Suicide occurs most often among Americans age 65 and older, mostly among men.  Some research shows that older adults with signs of depression had diminished immune responses.  This may affect their ability to fight off infectious diseases.

Depression is not a normal part of aging as many older adults and their caregivers think.  As people age they often experience many of the familiar triggers of depression, such as loss of loved ones, loss of physical abilities, and serious health problems.  Often physicians miss the signs of depression in older adults, thinking that symptoms they observe are the signs of aging.  At present, 5% to 10% of adults of all ages seeing family physicians at any given time are depressed.  About half of these cases, however, go undetected.  Experts in preventive medicine are encouraging family doctors to screen for signs of depression.  In doing so they can try to identify a potential problem even in those who do not report symptoms just as they do for high blood pressure and breast cancer.

When the diagnosis of depression is made early on with older adults, the patient can get relief from symptoms that complicate other problems.

(Understanding Depression, Harvard Health Publications; "Screening for Depression," Harvard Mental Letter, August 2002)

Depression and Heart Disease

Depression can strike anyone.  Research over the past two decades, however, has shown that people with heart disease are more likely to suffer from depression than otherwise healthy people.  On the other hand, people with depression are at greater risk of developing heart disease.  In addition to that, people with heart disease who are depressed have an increased risk of death after a heart attack compared to those who are not depressed.  Depression may make it harder to take the medications needed and to carry out the treatment for heart disease.  Treatment for depression helps people manage both diseases.  By doing so they enhance their survival and their quality of life.

Depression and anxiety disorders may affect heart rhythms, increase blood pressure, and alter blood clotting.  They can also lead to elevated insulin and cholesterol levels.

In spite of enormous advances in brain research in the past 20 years, depression often goes undiagnosed and untreated.  Warning signs are frequently misinterpreted, being mistaken for the inevitable accompaniments to heart disease.

People with serious illnesses such as cancer, diabetes, stroke or Parkinson's disease are also at greater risk of developing depression than the general population.  Diagnosis and treatment for depression helps manage the depression and the medical condition, thus improving quality of life.

(National Institute of Mental Health)

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